The use of a patient's healthy pulmonic valve as an autograft to replace a diseased aortic valve has been gaining worldwide acceptance as a viable alternative for replacing the patient's diseased aortic valve. This procedure is known as the Ross procedure after the surgeon who introduced the procedure in 1967.
The Ross procedure is performed by transplanting a patient's healthy pulmonic valve along with a portion of the pulmonary artery to replace the aortic valve and a few centimeters of the aorta. The left and right coronary arteries are attached to the valve wall of the pulmonary autograft after making small slits through the valve wall into coronary sinuses of the autograft.
The pulmonic valve is typically replaced by a homograft, such as a pulmonic or aortic heart valve from a cadaver. The Ross procedure is preferred over other heart valve replacement procedures, especially for individuals who are unable to take anticoagulation drugs. The Ross procedure has received substantial discussion in various publications.
For example, Oury et al., An Appraisal of the Ross Procedure: Goals and Technical Guidelines, Operative Techniques in Cardiac and Thoracic Surgery, Vol. 2, No. 4 (November), 1997: pp. 289-301, describes the Ross procedure as well as some alternative techniques for performing the procedure.
Black et al., Modified Pulnronary Autograft Aortic Root Replacement: The Sinus Obliteration Technique, Ann Thoracic Surgery, 1995; 60:1434-1436, describes a rather complicated technique to remedy a frequent problem of dilation of the pulmonary autograft following the Ross procedure. This approach utilizes large coronary buttons to replace the pulmonary sinus completely and leaves the non-coronary aortic sinus to support the non-coronary sinus of the pulmonary autograft.